Palliative Care is NOT “Death Panels”, Mr Limbaugh
As I awoke this morning, I heard Mr Limbaugh pointing out that if we did not think that Governor Palin was right about “death panels”, the Veterans Administration already had nurses doing this. When I recovered from realizing that this was not a nightmare or that I had become delusional, I became extremely upset.
The Veterans Administration offers one of the best Palliative care programs in the country. While nurses are involved in this program it is supervised by physicians many of whom have passed examinations to become experts in end of life care.It is now widely recognized that many persons at the end of life fail to receive appropriate care to relieve their symptoms. Palliative care does not mean no curative care; it means an appropriate mixture of curative and symptomatic care.
A palliative care program in Michigan showed that a nurse run program not only improved patient comfort but also EXTENDED life by nearly 50 days when compared to usual care from a cancer doctor. A study by Kaiser-Permanente found that a palliative care program improved patient and relatives’ satisfaction with care.
In the August 19th issue of JAMA, one of the leading medical journals, a study was reported that showed that a nurse-led, palliative care program improved quality of life and mood for cancer patients.
So why did Mr Limbaugh’s comments upset me? Because my faculty work with many people who benefit highly from great palliative care. Mr Limbaugh is highly respected by many persons throughout the country. His comments will deter patients, whose life could be greatly improved and who may even live longer by geting high quality palliative care, from receiving this care.Patients always have the choice to accept or not to accept palliative care. Nurses are truly the most appropriate persons to carry out much of this discussion with the patient.
I beg you, Mr Limbaugh, to talk to an expert in the field before you make medical comments like this that might result in many patients being harmed. I know you would never intentionally mean to do this.
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Dammert Professor of Gerontology and
Director, Division of Geriatric Medicine
Director, Gateway Geriatric Education Center
Department of Internal Medicine
Saint Louis University School of Medicine
and Director, GRECC,
St. Louis Veterans Affairs Medical Center 
bellow is a link to the transcript from Limbaugh’s show from 08/13/2009. is that the one you are commenting on?
http://www.rushlimbaugh.com/home/daily/site_081309/content/01125108.guest.html
No.This was in relationship to a short segment on the local KMOX radiostation on Thursday morning. As part of this, and I am paraphrasing, it was suggested that nurses in the VA were already trying to sign people up for death panels. I can only assume Mr Limbaugh was referring to the excellent palliative care program in the VAs. If this was not the case Id be happy to know what he was referring to.
I have to agree with Dr. Morley on his palliative care views. Studies demonstrate an actual increase in the days of a patient’s life involved in a hospice or palliative care program. When a nurse cares for a patient at home under these guidelines their needs are quickly addressed. No waiting for a doctors appointment, call backs, laying in an emergency room waiting for symptom control, etc. The physician and the nurse are a team in the comprehensive care of the patient and family. The patients are cared for, comforted, and the family is equipped with the knowledge they need to keep their loved ones at home.
I own and operate Nurses & Company Home Health Care, Hospice & Private Services. As a freestanding agency for 18 years, our nurses, therapists, and caregivers have excelled in their field evidenced by national recognition as a “Home Care Elite,” awarded to the top 25% of home care agencies. We are nurse-owned and managed, specialists in only home care, not being part and parcel of a huge hospital system or nursing home chain. It is by far the most cost effective means to care for patients at this time in their journey.
My only hope is that one day, at the end of my life, I personally wish to have someone (nurse-preferred) involved to facilitate my comfort and that of my family. So let’s assure that under the new health care reform bill that some of the proposed changes such as cuts for the elderly (500 billion dollars projected over the next 10 years, and 200 billion dollars of cuts to physician reimbursement) and bundling payments to hospitals for post-acute care, do NOT happen. At that point, well, bring on a panel and lets end it quick!
I am a geriatric nurse practitioner and I see elderly dying patients on a daily basis. Mr. Limbaugh’s comment about nurse-led palliative program offended me and I feel the nursing profession. Nurses in palliative care have had special training and are compassionate people. They often have more time to spend with the patients than physicians and help coordinate with the other disciplines, friends and family, the plan of care with that patient. Palliative care is not “just nurses”, it is a team of many disciplines… doctors, clergy, social workers, therapists etc. who work together.
I think people need to be educated in palliative care before they condemn it. Palliative care is a health care option and has many positive outcomes for many people. Please do not listen to those that are uneducated, and if needed, consider palliative care.
Why are some elderly citizens denied care, while other “seemingly more influential” parties get every available resource. Just look at Ted Kennedy. He got state of the art care, even with a bleak outlook. The doctors knew he was not going to survive, yet, he got the lastest treatments. I have a friend who is 78 years old. This guy has a torn rotator cuff and is in constant pain. But unfortunetly, he is not a Senator, and there is no doctor to repair his injury. They use the excuse, it will not benefit him. This guy is on medicare, too.
All the latest treatments didn’t help Ted Kennedy, but he got treated anyway. Maybe the proper term for “Death Panels” should be “withheld care” for unimportant people below the rank of Jr Representative.
PS. Why can’t the government go to univeral health insurance? Anbody (government employees included) under 65 gets a card and everybody (government employees) over 65 gets medicare. This plan would be paid for from the fund that generates the congressional health plan & the AIDs research fund. If you want to smoke, youre out of the plan, if you want to have gay sex,you are out too.
Oh and BTW: Rush is right Ditto ditto ditto.
Hi, Carolyn, pleasure to read your comment. Do you happen to have a transcript of Rush’s diatribe? I agree with what all three of you are commenting re palliative care…
The appropriate treatment of rotator cuff is a series of weight lifting exercises. These in most cases will cure pain. Rotator cuff surgery is variably successfully and requires the same exercises afterwards.So if my patient wont or cant do the exercises I rarely refer for surgery.medicare does not deny rotator cuff surgery for patients. Your friend needs to know this and discuss his options in detail or get a second opinion.
I have had the opportunity and privledge to be called upon by patients, families and physicians to initiate end of life discussions when patients and families are considering hospice services. In many situations this is the first time that patient and families are understanding the seriousness of the illness.
It never ceases to amaze me how many myths and misconceptions regarding the end of life still exist. Palliative care offers a sense of hope to patients by allowing symptom control, comfort and compassion to become their reality and not just a slight possibility. Palliative care is the one health care concept that we can agree on: it offers the patient/family some sense of control in a very “uncontrollable situation.” The physician and palliative care staff provide a coordinated patient/family centered care which is cost effective and addresses the physical, spiritual and psychosocial needs of the patient and family. Nurses have and will continue to be the most effective advocate that patients and familes have. The hospice concept (of which palliative care in an integral part) focuses more on maximizing one’s life versus emphasizing death.
We may differ on what the best “health care program” is but the palliative care concept needs to be a part of any program that’s implemented.
Palliative care is NOT no care. As a board certified palliative care physician I can tell you it’s a lot of work. Second, how does your correspondent below know that Ted Kennedy did not receive palliative care at the end of his life? Did you check his medical records? Palliative care means treat the symptoms that bother the patient. Along with appropriate medical disease management. The language gets extremely sloppy in these ideological blathers. Hospice is a physician-directed nurse-delivered service for intensive symptomatic care at the end of life when there are no effective disease management interventions left. Hospice is recognized as a reimburseable treatment by Medicare and most private insurers. The tragedy is that the uninsured have no access to merciful care when they are dying. I would encourage Mr. Limbaugh, who required medical detox for his pain killer addictions, to find the ideal health plan that will guarantee both immortality and no discomfort. I am not as sure as Professor Morley that Mr. Limbaugh means no harm. Sloppy language used with intent certainly achieves its purpose when in the hands of a professional rhetoritician.
Doc, funny you didn’t make this comment regarding many disturbing medical comments made by “Dr.” Obama:
“talk to an expert in the field before you make medical comments like this”